Occupational Therapy

Abstract 

Occupational therapy is prevalent in healthcare, especially in addressing the concerns of children and obesity. There are numerous risks if a child is obese or overweight including being bullied, marginalized, and facing obesity in later adulthood. Nevertheless, there are preventative and innovative approaches that are needed to reduce the health impact of childhood obesity for all societies and populations. An occupational therapist can assist in meaningful engagement and active participation to prevent children from obesity and an unhealthy lifestyle, but, at times, can become a challenge with the children's physical, social, emotional, or mental health (Pizzi, 2016). Occupational therapists can help to promote a healthy lifestyle with prevention, an increase in physical participation, and modify the existing environment in which the children live.

There is an increasing number of children that are becoming obese or overweight. The World Health Organization (WHO) reported that childhood obesity could increase to 70 million by 2025 worldwide if there are no steps taken to prevent obesity (Durbin, Baguioro, & Jones, 2018). Children facing obesity are at risk for many health conditions including high blood pressure, high cholesterol, diabetes, asthma, and mental health conditions such as depression and behavioral problems. Occupational therapists are extremely important for translating goals into practice to decrease these risks; for example, educating the youth and their families, providing water as a beverage option rather than pop, including the families in treatment sessions, and being an advocate through spreading awareness (Pizzi, 2016).

Another example of how occupational therapists can implement treatment prevention for obesity is making physical activity a priority through play and interaction with peers. This helps occupational therapists intervene and assess a child that is obese to ensure that occupational needs and applicable health are achieved (Pizzi, 2016). A study showed that if children who are overweight and obese follow a 60 min/day guideline, their risk of obesity may be reduced by 49% (Hong, Coker-Bolt, Anderson, Lee & Velozo, 2016). Occupational therapy practitioners may encourage this particular level of activity as an obesity prevention strategy that can be done with the support of physical education in school systems as well as communicating lifestyle awareness with children.

Occupational therapists' scope of practice includes consulting with many other professionals including nurses, nutritionists, teachers, etc. These professionals can promote a healthy lifestyle in diverse settings ranging from the schools, the community, and at home. ON the other hand, many environmental factors can be linked to an unhealthy lifestyle leading to obesity. These factors are strongly centered around the family structure at home such as single-parent families, socioeconomic status, and the lack of resources to obtain proper nutrition. Occupational therapists must consider the child's occupational challenges in these environmental contexts to provide the best possible outcomes.

The Affordable Care Act (ACA), also known as Obamacare, was passed on March 23, 2010. This Act was put in place to provide affordable healthcare insurance to a wider range of people in the United States. A section of the Act required health insurance providers to cover essential health benefits. Prior to the ACA, pediatricians avoided asking parents pertinent information regarding their child because they felt they were not adequately trained in specific areas such as mental health or obesity (Kuo, Etzel, Chilton, Watson, & Gorski, 2012). Once the ACA was passed, pediatric services were covered that included obesity screening and counseling. Therefore, the ACA requires health plans to cover services and allow pediatricians to treat health issues in children before it is problematic (Kuo, et al., 2012).

Preventative and wellness services is another essential health benefit included in the ACA. Insurance companies have helped people that are obese by developing weight loss and wellness programs at schools. A recent study entitled, The Healthy Hearts Program, supports the establishment of childhood obesity programs to decrease the risk of future health complications.

The study claims, routine awareness and practical ideas for incorporating more active time and healthy foods into children's activities of daily living, emphasizing easy strategies for changing task behaviors that might be detrimental to health (Kugel, Hemberger, & Javaherian-Dysinger, 2016). The outcome of the study helped not only the children to think of different ways they can be active, but helped the parents provide changes within the household to promote activity, such as watching television, as it relates to play and leisure (Kugel et al., 2016).

There is another program called CORD 2.0 that focuses on weight management to improve physical activity and healthy nutrition for children that are overweight or obese. This relates to the ACA as another prevention and wellness service for obesity. This relates to the ACA as another prevention and wellness service for obesity that also focuses on children from low-income households. Improvements are being made with Medicaid offices to provide accessibility for low-income families in attempt to promote a high degree of nutritional health and awareness that could be passed down through generations. This wellness and prevention program was created to gain knowledge and skills needed for a healthy lifestyle (CDC's Childhood Obesity, 2018).

Another component of the ACA as it relates to occupational therapy and childhood obesity is rehabilitative and habilitative services. These services help children to improve and learn functional skills. Occupational therapists work with these children that may face a variety of disabilities. Studies have shown that 40% of children with disabilities are at a higher risk of becoming overweight or obese (Pizzi, 2016). Therefore, occupational therapists have the opportunity to educate parents that have a child with a disability on proper nutrition and increase physical activity necessary for the child's development. Without these services, a child may not be able to go to school or participate in activities.

A final component in the ACA would be ambulatory patient services, or outpatient services. Children can receive care in outpatient services by completing weight management programs at the doctor's office. Occupational therapists can help children in these outpatient programs with socialization, education on health, and help children be engaged in meaningful activities.

It is important for people to be informed on the power of occupation as it relates to obesity and children. There are many themes within the essential health benefits in the affordable care act as it relates to occupational therapy services and childhood obesity. Occupational therapists must continue to promote healthy lifestyles, educate children and their families, and identify healthy occupations that are meaningful. Occupational therapists must continue client-centered care by using a holistic approach in order to improve quality care to clients and their families.

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